Is smokeless tobacco keratosis really leukoplakia?
Presented to the First International Conference on Smokeless Tobacco and Health, in Columbus, OH, May, 1991. White oral mucosal changes resulting from chronic smokeless tobacco (ST) use are usually designated as leukoplakias, and the extensive precancer literature relative to leukoplakia is presumed to apply to them. ST keratosis is, however, considerably different from leukoplakia, and the purpose of the present study is to demonstrate those differences as reported in the literature. Although both are precancerous, the malignant potential for leukoplakia (4%) is several magnitudes greater than that for ST keratosis (0.5%). And while both are white surface changes, ST keratosis typically presents as a smooth (perhaps fissured) gray/white, opalescent, velvety macule and usually remains so indefinitely, regardless of lenth of St usage. Leukoplakia plaques become very definitely white, continue to expand laterally and may become nodular and/or “speckled” (erythroleukoplakia) over time. Le
